Endocrine (27) Flashcards

1
Q

fluorescein angiography diagnoses ____ (sx: bleeding that causes sensation of falling curtain obstructing visual fields or eye floaters)?

A

diabetic retinopathy (**asx early in dz —> falling curtain sensation meaning vitreous bleed —> floaters that represent resolution of the bleed)

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2
Q

Lens refraction tests?

A

myopia (near sightedness), hyperoptia (far sightedness), astigmatism (irregular curvature of lens)

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3
Q

fluorescein staining dx what three things?

A

corneal abrasions, ulcers, infection (HSV, CMV)

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4
Q

how does fluorescein angiography work?

A

elucidate microaneurysm formation and neovascularization.

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5
Q

Subacute thyroiditis:

Phase 1: ____ wks of painful thyromegaly and hyperthyroidism. (inflammation induced release of thyroxine —> incr TSH)
Phase 2: ____wks asx, euthyroid
Phase 3: _____ time of hypothyroid (burnout of thyroid gland)

A

1 - 3-6wks
2 - 1-3 wks
3 - wks to mo

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6
Q

thyroid peroxidase antibody found in___ (a hypothyroid)

A

hashimoto thyroiditis

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7
Q

thyroid stimulating immunoglobulin is found in ____ (hyperthyroid)

A

grave’s disease

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8
Q

First step in tx of pt with pH 7.26, antion gap metabolic acidosis, elevated serum beta-hydroxybutyrate and urine ketones

A

this is alcoholic ketoacidosis:

  1. tx with thiamine
  2. NS and dextrose
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9
Q

how do you dx anaplastic thyroid carcinoma?

A

open surgical biopsy

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10
Q

mets of anaplastic thyroid carcinoma

A

LBB - lungs, bone, brain

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11
Q

MOA of metformin

A
  1. decreases hepatic gluconeogenesis

2. increases insulin sensitivity in peripheral tissues

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12
Q

CI to metformin:

Cr >____ in M or ____ in F.

A
  1. 5mg/L

1. 4mg/L

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13
Q

insulin, loops, reisns, alkalinizing agents, and Beta agonists (i.e. inhaled or systemic) are good for what ion abnormality?

A

good for reducing potassium, may cause hypokalemia.

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14
Q

Name the four ways of DM dx?

A
  1. fasting bs > or = to 126 on two occasions
  2. HbA1c > or = to 6.5% on two occasions
  3. 2 hr post oral GTT of bs > or = 200
  4. a random bs > or = 200 in a pt that already has sx
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15
Q

self limiting, rapid growing painless mass w/ or w/o sx of obstruction in neck. ey/hypo/hyerthyroid.

dx procedure?
dx?

A

open surgical biopsy to dx Reidel thyroiditis.

distinguish it from malignant anaplastic thyroid carcinoma

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16
Q

function of PTH

A

keep enough Ca in blood - release from bone

17
Q

parathyroid, pancreatic, pituitary adenoma =

18
Q

mucosal neuromas, marfanoid, pheochromo, medullary thyroid ca = ?

19
Q

parathyroid hyperplasia, pheo, medullary thyroid Carcinoma

20
Q

What does this outcome of HD-dexamethasone test mean?

ACTH undetectable and cortisol not suppressed

A

Primary hypercortisolism (tissue producing cortisol w/o regulation or ACTH stimulation)

Dx: HD-dex suppression test

21
Q

What does this outcome of HD-dexamethasone test mean?

ACTH elevated and cortosol not suppresed

A

ectopic ACTH production (Cushing’s syndrome) –> paraneoplastic syndrome producing ACTH

Dx: Chest CT and abd CT

22
Q

two cancers that cause paraneoplastic syndrome producing ACTH.

A

adrenocortical carcinoma

small cell lung carcinoma

23
Q

What does this outcome of HD-dexamethasone test mean?

high-normal ACTH and suppressed cortisol

A

ACTH pit adenoma (B9 tissue producing too much ACTH) –> cushing disease

(Dx: pit MRI)

24
Q

first step in dx euthyroid pt (normal TSH) with thyroid nodule

A

FNA to distinguish b/w B9 and malignant thyroid tumors

25
if thyroid nodule is found and TSH is low, what are the three findings of a radioactive iodine?
hot - increased activity (B9) warm - same uptake as surrounding tissues --> FNA next cold - decreased uptake --> FNA next
26
First line medication for prevention of progression in a person with a T score of below -2.5 (or @risk -1.5 to -2.4)
osteoporosis DoC tx bisphosphonate (ibanDRONATE) for TX and PREVENTION or denosuMAB
27
vitamin D, Ca, vit A, thiazide diuretics, lithium can all cause....(stones, bones, abd groans, psychic overtones)
hyperCa and hyperPTH stones - nephrolithiasis bones - osteoporosis abd - cramps, N/V/constipation psychic - anxiety, depressed
28
in what population are HbA1c readings inaccurate?
CKD! HA, Sickle Cel, EPO therapy
29
how can diabetic gomerulopnephropathy be prevented - add ___ class? (all DM should be on this)
add ACE inhibitor (-prils) --> inhibits constriction of efferent renal arteriole
30
edema, hypoalbuminemia, proteinuria >3g/d
diabetic Glomerulonephropathy with nephrotic syndrome
31
most sensitive test for hypothyroid
1) serum TSH --> then do 2) T4
32
94% specificity means...
94% of people w/o the disease test negative - it correctly assesses disease free pts 94% of the tie
33
Tx of choice for hyperparathyroidism with osteoporosis
Parathyroid gland removal
34
pre diabetes HbA1c range
5.7-6.4%
35
hyperthyroid sx controlled with:
beta-blockers (i.e. -olol) PTU adn methimazole are antithyroid, but take 2-8wks to reduce excess thyroid hormone production